Understanding Frozen Shoulder / Adhesive Capsulitis

Frozen shoulder, scientifically termed adhesive capsulitis, is a complex and often painful condition that affects the shoulder joint. In this post, I’ll explain what frozen shoulder is, explain the anatomy of the shoulder joint, the progressive states of the condition, potential causes, and the impact it has on individuals.

Anatomy of the Shoulder:

To better understand frozen shoulder, it's important to understand the complexity of the shoulder joint. The shoulder is comprised of three main bones: the humerus (upper arm bone), the scapula (shoulder blade), and the clavicle (collarbone). These bones, along with muscles, tendons, and ligaments, work together to allow the large range of motion of the shoulder.

What is Frozen Shoulder?

Frozen shoulder is characterized by inflammation, thickening, and tightening of the shoulder capsule—a connective tissue that encases the joint. This process results in a progressive reduction of the joint's synovial fluid, which lubricates and nourishes the joint, leading to increased friction and stiffness. As the condition advances, the capsule becomes less elastic, restricting movement and causing discomfort.

Progressive Stages of Frozen Shoulder:

1. Pain (Freezing Stage):

   • Onset: Gradual and insidious.

   • Nature of Pain: Often described as a deep ache or sharp pain.

   • Timing: Pain is typically exacerbated by movement.

   • Functional Impact: Activities such as reaching overhead or behind the back become increasingly challenging.

2. Stiffness (Frozen Stage):

   • Characteristics: Pronounced stiffness and limited range of motion.

   • Functional Impact: Difficulty with routine tasks, such as dressing or combing hair.

   • Progression: Stiffness intensifies, leading to a significant reduction in shoulder mobility.

3. Thawing Stage:

   • Characteristics: Gradual improvement in shoulder mobility.

   • Timeline: Recovery can span several months to years.

   • Remaining Challenges: Despite improvement, some individuals may experience residual stiffness.

Potential Causes of Frozen Shoulder:

The precise cause of frozen shoulder remains unknown, but several factors may contribute:

1. Inflammation: Inflammatory processes within the shoulder capsule may trigger the development of adhesive capsulitis, such as inflammation resulting from a traumatic injury.

2. Immobility: Prolonged immobilization of the shoulder joint due to injury, surgery, or medical conditions can increase the risk of frozen shoulder.

3. Connective Tissue Disorders: Individuals with certain connective tissue disorders may be predisposed to adhesive capsulitis.

4. Diabetes: There is an observed association between diabetes and an elevated risk of developing frozen shoulder, although the underlying mechanisms are not fully understood.

5. Age and Gender: Frozen shoulder is more prevalent in individuals aged 40 to 60 and is more commonly diagnosed in women than in men.

Frozen shoulder can have a profound impact on daily activities, affecting everything from basic self-care to work-related tasks. As the condition progresses, individuals may find themselves struggling due to limitations in their range of motion and experiencing persistent discomfort.

If you suspect you may be experiencing symptoms of frozen shoulder, seeking professional evaluation and guidance is critical. Please reach out if you have any questions or want to know how physical therapy can help.